Science, Belief, Psychology and Nonsense

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“The good thing about science is that it’s true whether or not you believe in it.” ― Neil deGrasse Tyson

I want very much to be on the side of science. The scientific method is perhaps the most powerful and influential tool in all of human existence. A long line of dedicated scientists have blessed us with electric light, the eradication of smallpox and polio, a steady food supply, clean water, air conditioning, and every bit of computer technology ever known just to name a very few things. That said, I will admit my own confusion and I will admit adherence to various practices and ideas that don’t hold up to vigorous scrutiny. (I’m trying to do better.)

Mention the word “science” to some people and they’ll take it as a dirty word. Some don’t like the pointy-headed image of scientists telling us certain unfortunate truths (climate change is man-made for instance.) Others among us have been scared by genetically modified food (GMOs) and vaccines. This is unfortunate for a lot of reasons. Many of us walk around in needless fear for instance. More specifically, fear of vaccines has led to needless outbreaks of disease. Famously, Steve Jobs delayed rejected science-based cancer treatment for complimentary/alternative medicine (CAM.) According to his biographer, Jobs regretted this decision.

Some people think that “science” equates to “Western medicine,” or “pharmaceuticals.” Not true. There’s plenty of non-scientific practices and methods employed by modern medicine and the pill companies. In fact, good, thorough, rigorous science can expose the ineffective or dangerous aspects of medicine and drugs. In Bad Science and Bad PharmaBen Goldacre has done a great job discussing the misuse and abuse of science by both complimentary/alternative medicine and the pharmaceutical industry.

Skepticism

Skepticism is useful. This is a questioning point of view. A skeptic requires solid evidence before he or she believes something. Being skeptical means you’ve set a high bar for your beliefs. You don’t accept information at face value. Nor do you accept anecdotal evidence or information gained from an “experiment of one.” Healthy skepticism can save us money and may save our health. Here are some things that I understand about skepticism: When we hear about a “miracle cure,” “secret trick to whatever-it-is-you’re-dreaming-about,” “startling breakthrough” or “what the doctors don’t want you to know,” the skeptic in us should come to life and pay close attention to what we’re being told. It’s probably nonsense!

(BTW, skepticism doesn’t equal cynicism. Skepticism is not a negative thing. A skeptic simply asks for valid evidence to be shown.)

Correlation and Causation

Today I wore green shorts. I didn’t throw up. Green shorts prevent nausea! They protect against throwing up! I know it to be true because I was there and I witnessed it. That’s proof enough for me. “I know what works for me.”  

Does this sound familiar? Does this line of thinking make sense?

Here’s another example: Someone gets acupuncture for seasonal allergies (or any other ailment you care to think of) and some time soon after they feel better. Someone could see this as “proof” that acupuncture “works” to cure allergies. So every time this person feels their allergies come on, he or she gets acupuncture and soon the symptoms are gone. This could be fairly convincing to a lot of people that acupuncture works very well at curing an illness.

Acupuncture correlates to the resolution of the illness. But did acupuncture cause the illness to go away? Here are some things to think about: Why do we seek treatment for an illness? Typically people seek help because the symptoms are too tough to deal with. Guess what usually comes on the heels of our bad symptoms whether or not we seek treatment or not: We feel better! There’s a normal course that most illnesses take and it doesn’t usually end with us in the grave. Rather, our immune system fights off the illness and we feel fine, acupuncture or no acupunctureChiropractic adjustment or no adjustmentHomeopathy or no homeopathy. So what would we say if someone got acupuncture and they felt worse? What if someone did not receive acupuncture and he or she felt better soon anyway? All of these are possible outcomes. We might think that acupuncture doesn’t have much relationship to illness at all.

Fitness

“I consider corrective exercise to be the alternative medicine of the fitness field.”
– Coach Nick Tumminello 

That statement has given me a lot to chew on, and I am coming around to agree with him. The fitness universe abounds in various systems and methods that promise better movement and less pain. All of them are sold by people with impressive credentials who use technical and scientific-sounding terminology. I have absolutely fell under the spell of some of these systems.

Now I look back and realize that either a) I should’ve been more skeptical towards some of the claims I’ve heard or b) because I was searching desperately for a solution to my 10-year-long chronic back pain, I was ready to believe many things told to me by those who spoke with certainty–even though I tiny voice in the back of my head may have been questioning those claims.

Tumminello has written a series of posts on his blog that discusses the psychological factors that make us susceptible to faulty thinking. He’s aimed this series at the fitness community but he really discusses psychological tendencies that all humans seem to share–no matter how smart or well-informed we are. Why Smart Trainers Believe Stupid Things: Part 1 discusses bias toward positive evidence.  In Part 2 we learn how “authorities” can use jargon and inflated language to sway us. Part 3 goes into regression to the mean (discussed previously) and why it’s easy to believe a given treatment may “work” when in fact the thing the treatment was meant to fix has simply run its natural course. Psychological reasons why coaches will never stop arguing; training debates are a waste of time; and the fitness industry will never be united (long title) is very similar in tone and content to the previous articles.

These articles were very illuminating to me. If you’re a critically thinking fitness professional, they may help sharpen your thinking quite a bit.

New Thinking

As I’ve said, I’ve swallowed some nonsense and falsely ascribed amazing results to methods that simply didn’t do what I believed. The health & fitness field is perhaps more awash in phony gurus and foolish hocus pocus than almost any discipline on earth.  (Religion may take 1st place.) From medicine to food to exercise–especially corrective exercise–there are numerous minefields out there. Misinformation and half-baked nonsense is widespread on the Internet so I must be careful what to believe.

The best snake-oil salesmen blend truth with bull$hit.  (Dr. Oz comes to mind.) I need to examine each statement and claim from the person making it. I shouldn’t give the benefit of the doubt to anyone based on their credentials, popularity or status.

Rather than seek out information that confirms my beliefs, I need to look for evidence that actually disproves what I believe. (That’s a tough one!)  I should be prepared to set aside my beliefs when solid evidence contradicts those beliefs.

There are a lot of cases where making leaps in thinking leads to inaccuracies.  Nutrition is rife with this type of thing. The fat-causes-heart-disease idea seems to be in this category. A researcher may expect that A causes B–animal fat consumption causes heart disease for example–but this conclusion may be based on animal studies or educated guesses. What should happen isn’t necessarily what actually happens, yet many of our Federal dietary guidelines have been based on assumptions, not evidence.

I need to be (more) aware of my biases and my emotions. I should be aware of my herd mentality and I shouldn’t be afraid to ask questions. If a proponent of something wonderful can’t or won’t answer my questions, or uses excessively big and complex language in their explanation, I should beware.

Other non-BS resources

I’ve found some useful resources for evidence-based information. There must be many more out there. Here are a few:

  • Genetic Literacy Project: Lots of good information on GMOs.
  • Science Based Medicine: A wide range of medical information. From vaccines to chiropractic to acupuncture, nutrition, evolution, veterinary medicine and a lot more.
  • Soma Simple: This for manual therapists, physical therapists, pain management people and coaches. It’s a very high bar to cross if you want to put out your ideas. The group here demands evidence. I’ve learned a ton about pain science here and I’ve been made aware of a lot of the exercise baloney that’s out there.
  • Evidence Based Fitness: Bryan Chung does a great job of discussing and laying out the research facts on the latest fitness research.
  • Exercise Biology: Similar to Evidence Based Fitness. Anoop T. Balachandran discusses the evidence pertaining to strength training, pain, nutrition, supplements and more. His post on pain should be required reading by all trainers and coaches.
  • How to Detect Bullshit: My article wouldn’t be complete without a link to this fine piece of writing from Scott Berkun. I might need to read it several times.

“Bad Science” is a good read.

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Cures all that ails!!

Unless you live in a sensory deprivation chamber, you know that we’re awash in news stories and advertisements for food products, drugs, pain remedy potions, supplements of various sorts and all kinds of fitness and health fads.  White-lab coated doctors appear on popular TV shows extolling the virtues of antioxidants, fiber, raw foods ionized bracelets, colonic cleanses and more.

We’re often told these products are “clinically proven” or that “Studies show” huge life-changing success when we use these products.  But what do these terms mean?  Are the hard-to-believe claims possibly true? Which if any of these “sciencey” sounding products are worthwhile, effective or even safe?  I’m not a scientist, so what should I believe?  (I should add that I’ve probably been convinced more than a few times of the worth of some worthless things.)

In an effort to understand some of this stuff, I’m reading Ben Goldacre’s Bad Science, and I’m learning a lot. He discusses in clear terms some of the strange claims made by practitioners of complimentary alternative medicine (CAM) such as homeopaths and nutritional gurus.  We learn about the extraordinarily powerful placebo effect and why this effect is often at the core of alternative treatment methods.  We get an in-depth look at the shocking and strange situation surrounding the recent HIV/AIDS denial controversy in South Africa.  (This was the conflict in which South African president Thabo Mbeki and his cohorts fully ignored all scientific data regarding treatment and prevention of HIV/AIDS.  The result was many thousands of premature deaths due to denial of antiretroviral drugs to HIV/AIDS patients in that country.  One man, Mathias Rath, a German vitamin pill peddler, profited tremendously from this situation.) Goldacre also takes the pharmaceutical industry to task for various dubious, dangerous practices and manipulation of data. Bad Science is a look inside all sorts of snake oil.

Thus far I’ve found the chapter on nutritionists particularly interesting.  We get some history of nutritional quackery.  We learn about a man named John Harvey Kellog. You may recognize his last name.  He helped create the cornflake. He sold granola bars, ran a sanatorium where patients were treated with “holistic methods,” advocated colonic cleansing which is popular today (By the way, that’s putting stuff in through a very clearly marked exit.), and he campaigned vigorously against masturbation. (He had some particularly stringent views on incorporating pain into circumcision as a way of inhibiting the enjoyment of sex in boys, and he advocated using carbolic acid on the clitoris to similarly dissuade sexual excitement in girls.)

What you start to realize is that ALL this stuff has been around for a long time.  Charlatans making outrageous “sciencey” claims have been with us for decades if not centuries.  They claim in one breath that cutting edge science is on their side.  Yet when their methods and practices are subjected to truly rigorous scrutiny–and their methods are shot full of big holes–they huff and puff (sometimes they sue) and insist that the medical community is against them.  Beware of these people.  A lot of them–guys like Dr. Oz, Andrew Weil, Deepak Chopra–are very popular and highly respected in some circles including the popular press.  They’re entertaining and they deliver very interesting messages.  They also run in quite another direction from much of mainstream science.

If we’re looking to summarize the differences between CAM and conventional medicine, the following statement from the site Quackwatch.com says it best:

“Until now, alternative medicine has generally been rejected by medical scientists and educators, and by most practicing physicians. The reasons are many, but the most important reason is the difference in mentality between the alternative practitioners and the medical establishment. The leaders of the establishment believe in the scientific method, and in the rule of evidence, and in the laws of physics, chemistry, and biology upon which the modern view of nature is based. Alternative practitioners either do not seem to care about science or explicitly reject its premises. Their methods are often based on notions totally at odds with science, common sense, and modern conceptions of the structure and the function of the human body. In advancing their claims, they do not appear to recognize the need for objective evidence, asserting that the intuitions and the personal beliefs of patients and healers are all that is needed to validate their methods.”

One statement I found resonated with me, and I think it will help me keep a proper perspective. “There’s a word for alternative medicine that holds up to scientific scrutiny: Medicine.”

Goldacre doesn’t spend all his time bashing CAM, just most of his time.  Early in the book he discusses one area where many CAM practitioners outdo their conventional medical counterparts and that’s in listening to the patient.  A huge part of a patient’s feeling better relies on the doctor/patient relationship–the doctor’s bedside manner.  Many of us have experienced a doctor’s appointment in which we’re rushed through, talked down to, not listened to, and the doc doesn’t do a good job of explaining what’s happening.  This does not help us feel better.  In contrast, much of the benefit of CAM may lie in the experience of someone taking time to genuinely listen to us, thus calming us and giving us hope that we can feel better.

Bad Science is a fun, snarky read.  Goldacre’s criticism of the CAM industry is very direct.  At times he’s sarcastic and creatively belittling of alternative medicine. If you’re an advocate of CAM then you might get a little worked up and defensive.  If you’re interested in getting a deeper understanding of all the confusing medical and pseudo-medical information around us, please get a copy of Bad Science. You don’t have to be a scientist to understand what Goldacre is saying.  For more fun and good information, have a look at Goldacre’s site BadScience.net.